Abstract

P 018

Alternative repair method of perforated marginal corneal ulcer

Pegah Heidari, Walter Sekundo

Augenklinik, Standort Marburg, Universitätklinikum Gießen und Marburg, Marburg

Objective
Corneal full thickness patch or a penetrating keratoplasty is used in cases of a perforating corneal ulcer. These methods require a long-term post-operative topical steroid therapy.
Methods
A 83-year-old male patient in a poor general condition caused by a congestive heart failure, presented with a feeling of pressure on the left eye. On examination we observed a marginal corneal perforation with iris incarceration on the left side.
The patient could not remember any trauma, but have had a foreign body injury. The visual acuity was 0.9 in the right eye and 0.32 in the left eye. At that time the patient was treated in the department of cardiology because of his global heart failure due to dilatative cardiomyopathy with hypostatic pneumonia.
Results
During the following days the general condition of the patient got worse and he was taken to the intensive-care unit. Because of the multimorbidity and the unpredictable prognosis we decided to cover the perforation with the patients own scleral and conjunctival flap. After operation a short term topical therapy with ofloxacine was initiated. There was no irritation or leakage post-operatively.
Conclusions
The covering of corneal lesions with the patients own scleral and conjunctival flap is a possible option for patients who are not able to take eye drops over a long period of time. There are less postoperative complications, because there is no danger for tissue rejection.

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